Post Thrombotic Syndrome (PTS)


Post thrombotic syndrome (PTS) is a chronic (long term) problem that develops after a patient has a clot in the deep veins of the legs (deep vein thrombosis;DVT). PTS develops because the clot blocks blood flow returning to the heart leading to increased pressure in the veins of the legs.

What are the main symptoms of PTS?

The increased pressure in the veins may lead to problems of pain, swelling and changes in the skin including the development of ulcers (also called venous ulcers or stasis ulcers). Other symptoms of PTS include cramps, itchiness and heaviness of the legs.

How often does PTS develop?

It has been estimated that 1 in 3 of patients who develop clots in the veins of the legs will develop some symptoms of PTS.

Why does PTS develop?

The exact reason why PTS develops is not known. Blood clots and blockage in the veins leads to increased pressure in the veins. This disturbs the blood circulation of the legs leading to the symptoms of PTS.

Can PTS be prevented?

It is important to try and reduce the risk of developing PTS after developing a clot in the legs. An important way to decrease the chance of developing PTS is to use compression stockings (See information sheet on Graduated Compression Stockings).

Compression stockings can be used to reduce the swelling, improve blood flow in the legs and avoid the risk of developing PTS. Compression stockings need to be used for a long time after developing a clot in the legs.

What can be done for PTS once it has developed?

Once PTS has developed it is difficult to manage. Prevention is important but once the symptoms of PTS have developed there are some approaches to decrease the symptoms.

The main way to decrease the symptoms is to reduce the pressure in the veins by elevation of the leg where possible and to use compression stockings. Specially designed compression stockings are available for people who have problems with PTS. Surgery in PTS is not generally recommended since the affects of surgery can be more severe than the symptoms of PTS.

Resources used to produce this information sheet.

  1. Non-pharmaceutical measures for prevention of post-thrombotic syndrome. Cochrane Database of Systematic Reviews 2006(Issue 4).
  2. Antithrombotic therapy for venous thromboembolic disease: the Seventh ACCP Conference on Antithrombotic andThrombolytic Therapy. Chest. :401S-428S, 2004;126(3 Suppl).


The information presented in this fact sheet is intended as a general guide only. Patients should seek further advice and information about Post Thrombotic Syndrome (PTS) and or their individual condition from their treating haematologist or doctor.

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